2021
DOI: 10.1001/amajethics.2021.109
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How Should Clinicians Respond to Language Barriers That Exacerbate Health Inequity?

Abstract: Patients and families with limited English proficiency (LEP) face barriers to health care service access, experience lower quality care, and suffer worse health outcomes. LEP is an independent driver of health disparities and exacerbates other social determinants of health. Disparities due to language are particularly unjust because LEP is morally irrelevant and a source of unfair, unnecessary disadvantage. Clinicians and health care organizations have duties to intervene, which this article describes. To clai… Show more

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Cited by 24 publications
(6 citation statements)
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“…They were keenly aware of patient-physician language discordance as an overlooked force in healthcare interaction. 35 Social exclusion, which speaks broadly to the deleterious effects that denial of social goods such as healthcare and language services can have on health, is among the 14 social determinants of health operant in the Canadian context. 36 While we have focused on the particular example of an official language in Canada, we believe that our analysis more broadly implies that it is time to consider language—the medium through which healthcare encounters flow—as a social determinant of health in and of itself.…”
Section: Discussionmentioning
confidence: 99%
“…They were keenly aware of patient-physician language discordance as an overlooked force in healthcare interaction. 35 Social exclusion, which speaks broadly to the deleterious effects that denial of social goods such as healthcare and language services can have on health, is among the 14 social determinants of health operant in the Canadian context. 36 While we have focused on the particular example of an official language in Canada, we believe that our analysis more broadly implies that it is time to consider language—the medium through which healthcare encounters flow—as a social determinant of health in and of itself.…”
Section: Discussionmentioning
confidence: 99%
“…As suggested in other studies (Mukadam et al, 2011;Sagbakken and Kumar, 2017), our study shows that knowledge about dementia and formal care support is essential to help-seeking behaviour. Also, studies show that when PwM experience language barriers, it is difficult to advocate for themselves, ask questions and navigate health-care systems (Gengler, 2014;Espinoza and Derrington, 2021). This may explain why families with a migration background often do not seek formal support in an early stage of dementia (Mukadam et al, 2011), and why PwM often receive delayed diagnosis or inadequate treatment for dementia (Chin et al, 2011).…”
Section: Discussionmentioning
confidence: 99%
“…[10][11][12] However, the usefulness of a language-based PROM is restricted if patients and families have limited English proficiency, which is a barrier to healthcare services that is well documented. 13 Singapore is primarily an English-speaking country. However, her geographical location and historical and cultural backgrounds greatly influence the languages used in this city-state.…”
Section: Open Accessmentioning
confidence: 99%